Price Rebecca B, Beltz Adriene M, Woody Mary L, Cummings Logan, Gilchrist Danielle, Siegle Greg J
Department of Psychiatry, University of Pittsburgh School of Medicine.
Department of Psychology, University of Michigan.
Clin Psychol Sci. 2020 May 1;8(3):491-505. doi: 10.1177/2167702620906149. Epub 2020 Apr 22.
On average, anxious patients show altered attention to threat-including early vigilance towards threat and later avoidance of threat-accompanied by altered functional connectivity across brain regions. However, substantial heterogeneity within clinical, neural, and attentional features of anxiety is overlooked in typical group-level comparisons. We used a well-validated method for data-driven parsing of neural connectivity to reveal connectivity-based subgroups among 60 adults with transdiagnostic anxiety. Subgroups were externally compared on attentional patterns derived from independent behavioral measures. Two subgroups emerged. Subgroup A (68% of patients) showed stronger executive network influences on sensory processing regions and a paradigmatic "vigilance-avoidance" pattern on external behavioral measures. Subgroup B was defined by a larger number of limbic influences on sensory regions and exhibited a more atypical and inconsistent attentional profile. Neural connectivity-based categorization revealed an atypical, limbic-driven pattern of connectivity in a subset of anxious patients that generalized to atypical patterns of selective attention.
平均而言，焦虑患者对威胁的注意力表现出改变，包括早期对威胁的警觉和后期对威胁的回避，同时大脑区域间的功能连接也发生改变。然而，在典型的组间比较中，焦虑症在临床、神经和注意力特征方面的显著异质性被忽视了。我们使用一种经过充分验证的数据驱动方法来解析神经连接，以揭示60名患有跨诊断焦虑症的成年人中基于连接性的亚组。通过独立行为测量得出的注意力模式对这些亚组进行外部比较。出现了两个亚组。A组（68%的患者）对感觉处理区域表现出更强的执行网络影响，并且在外部行为测量中呈现出典型的“警觉-回避”模式。B组的定义是边缘系统对感觉区域的影响更大，并且表现出更不典型和不一致的注意力特征。基于神经连接的分类揭示了一部分焦虑患者中存在非典型的、由边缘系统驱动的连接模式，这种模式普遍存在于选择性注意力的非典型模式中。
